Natural disasters accumulate post-traumatic stress (PTSS) symptoms and functional impairment in individuals, whether they are directly affected, indirectly through concern for friends or family, or even through media coverage, a survey-based analysis of two hurricanes found.
The strongest association with PTSS after Hurricane Irma in 2017 was from direct loss or injury (unstandardized b-coefficient 0.35, PJAMA network open.
But prior hurricane-related casualties or injuries, prior mental illness, failure to evacuate from an evacuation zone, and even hurricane-related media exposure were also all associated with a linear increase in PTSS after Hurricane Irma (b 0.03-0.18).
“It might seem small, but that’s the average of over 1,600 people,” Garfin noted, allowing some individuals to have a larger impact.
Hurricane Irma-related PTSS was positively associated with post-Hurricane PTSS and functional impairment 1 year later, independent of demographic, socioeconomic, life events, physical losses due to hurricanes, and pre-hurricane mental health.
In short, people who were repeatedly directly or indirectly exposed to hurricanes had increased mental health symptoms, suggesting that they were more vulnerable to mental symptoms with each disaster, the group concluded.
“As we face escalating weather-related disasters – many of which will become more severe and frequent due to climate change – we can expect a mental health crisis, as our study shows that over time, people don’t take it.” get used to the effects of these disasters. They have additional implications,” Garfin said MedPage today. “The more people who have experienced these events, the worse their mental health is.”
Participants in the study experienced global distress (a combination of depression, anxiety, and somatization) as well as persistent anxiety and worry. Garfin found that these symptoms increased over time and correlated with functional impairments, suggesting that these experiences affected their daily social life.
in one comment Accompanying the paper, Masaki Nakabayashi, PhD, suggested that these findings could be applied to many other types of disasters, such as Southeast Asia hurricanes and East Asia typhoons, as well as global health pandemics like COVID-19. He indicated that these findings could provide the basis for a more comprehensive analysis of the impact of these disasters on populations, which in turn could lead to “more practical policy implications for harm reduction”.
Nakabayashi also added that the research could inform studies on whether “the recurrent waves of COVID-19 and the increase in the number of infections may be similarly associated with adverse mental health outcomes.”
Garfin’s group surveyed 2,873 Florida residents before Hurricane Irma made landfall in South Florida between September 8 and 11, 2017. They received 1,637 responses (57.0%) from this first wave of surveys. A month later, they sent follow-up surveys to these respondents and had 90% retention from wave 1. Another follow-up survey was sent between October 22nd and November 11th. August 2018, after Hurricane Michael hit the Florida Panhandle. They received 1,113 responses to this survey (75.3% retention from wave 2; 66.7% retention from wave 1).
The surveys lasted 15 to 20 minutes with responses on a 5 point scale depending on the information targeted.
Among the first 1,637 respondents in Wave 1, the median age was 51 and 55% were women. Overall, 83.6% of participants reported no prior diagnosis of mental illness, 11.4% reported having depression or anxiety, and 5% reported both diagnoses.
Respondents reported that they were exposed to media related to Hurricane Irma for an average of 7.9 hours, including 3.8 hours of television, radio and print news; 2.2 hours of online news; and 1.9 hours of social media.
The survey was a slog and a colleague had been waiting a long time for an opportunity to administer it. As Hurricane Irma prepared to make landfall in South Florida, they quickly secured grant funding and ethical approval to conduct the first wave of the survey in just days.
Given the fast turnaround time, the team was surprised by the response rate from study participants, Garfin said. She noted that given the circumstances for the participants, a much lower response rate might have been expected.
“I think it actually speaks to the fact that people are interested in taking surveys and responding to things that are important to them,” Garfin said. “I think that’s why we’ve also been able to maintain strong follow-up, because this is something that people care about. They wanted to share their experiences with us.”
The study was funded in part by grants from the National Science Foundation.
Garfin reported receiving grants from the National Science Foundation and the National Institute on Minority Health and Health Disparities. Co-authors reported on grants from the National Science Foundation.
Nakabayashi did not report any disclosures.